Lenacapavir,
the
first
twice-yearly
HIV
prophylactic in
the
world,
is
set
to
be
rolled
out
in
Zimbabwe,
one
of
10
countries
selected
for
the
initial
rollout
of
the
injectable
drug.
“We
are
excited
to
announce
that Zimbabwe
was
selected as
one
of
the
10
countries
globally
to
roll
out
lenacapavir,
a
breakthrough
development
in
the
fight
against
HIV,” the
US
Embassy
in
Harare
said
in
a
post
on
X.
Zimbabwe
has
one
of
the
highest
HIV
prevalence
rates
in
the
world,
with
1.3
million
people
living
with
the
condition,
according
to figures from
UNAIDS,
the United
Nations program
on HIV/AIDS.
The
southern
African
nation
recently
met
the
UNAIDS
95–95-95
fast-track
targets,
meaning
that 95%
of
those
living
with
HIV
know
their
status;
95% of
those
who
know
they
have
HIV
are
on
life-saving
antiretroviral
treatment;
and
95%
of
people
on
treatment
achieve
viral
suppression.
Ponesai
Nyika,
a public
health
expert
with
extensive
experience
in
HIV/AIDS
research
and
program
implementation,
told
DW
that
Zimbabwe
has
a
“very
solid
HIV
response
infrastructure.”
The
introduction
of
lenacapavir
is
expected
to greatly
boost
Zimbabwe’s
efforts
to
eradicate
infections.
“Supported
by
strong
partnerships
like PEPFAR [the
US
President’s
Emergency
Plan
for
AIDS
Relief] and
other
local
institutions
…
creates
a
solid
foundation
for
the
introduction
of
lenacapavir,”
Nyika
added.
Zimbabwe’s
rollout
will
target
people
susceptible
to
HIV
infections
—
including
adolescent
girls
as
well
as
those
who
are pregnant
and
breastfeeding.
Why
is
lenacapavir
considered
a
game
changer?
The World
Health
Organization
(WHO) has
hailed lenacapavir
as a transformative
step
forward in
protecting
people
at
risk
of
HIV.
“While
an
HIV
vaccine
remains
elusive,
lenacapavir
is
the
next
best
thing:
a
long-acting
antiretroviral
shown
in
trials
to
prevent
almost
all
HIV
infections
among
those
at
risk,”
said
WHO
Director
General Tedros
Adhanom
Ghebreyesus.
Ugandans
hope
for
access
to
HIV
injection
drug,
Lenacapavir
UNAIDS
has
also
described
the
drug
as
a
watershed
moment
in
HIV
response.
“We
are
talking
about
it
as
a
potential miracle
drug,”
Angeli
Achrekar,
deputy
director
of
UNAIDS,
told
DW.
“Right
now,
the
fact
that
it
is
nearly
100%
effective
at
stopping
new
infections
is
remarkable,
it’s
unprecedented.
It’s
the
best
thing
we’ve
got
in
the
HIV
response.
We
do
not
have
a
vaccine
or
cure,
but
this
is
extraordinary.”
Lenacapavir
is
expected
to
be
rolled
out
across
120
low-
and
middle-income
countries
by
2027
and
is
anticipated
to
significantly
reduce
the
1.3
million
new
HIV/AIDS
infections
yearly.
Nyika
told
DW
that
the
drug
is
seen
to
be
“highly
effective.”
“Specifically
for
HIV
prevention,
it
has
been
seen
to
be
highly
effective,
which
is
what
makes
it
very
exciting
compared
to
the
others.
It
is
highly
effective
in
preventing
HIV
infections
if
used
correctly
and
consistently,” Nyika
said.
The
drug
has
gone
through
two
trials:
One
in
sub-Saharan
Africa
among
women
and
girls,
the
other among
American gay
and
bisexual
men
and
transgender
women.
In
both
trials,
the
efficacy
of
the
drug
was
more
than
99%,
raising
hope
for
its
“extraordinary” abilities
in
HIV
prevention
once
fully
available.
Nyika
further
explained that
the
administration
of
the
drug
only
twice
a
year
makes
it
even
more
effective
as
it
reduces
incidents
of
low
adherence
to
HIV
treatment.
Mixed
reactions
While
some
Zimbabweans
are
upbeat
about
the
introduction
of
the
medication,
others
are
more
skeptical
about
the
drug’s cost,
safety and
accessibility.
But
Nyika
argues
that
while
lenacapavir
—
like
every
new medication
—
can
have
some
side
effects,
“the
data
that
we
have
does
show
that
lenacapavir
is
very
safe
and
well
tolerated.”
He
urged
African
countries
rolling
out
the
drug
to
be
transparent
and
communicate
clearly
about
any side
effects
of
the
drug
to
aid
in
its
adoption.
How
to
protect
your
baby
from
HIV
Despite
significant
praise
for
the
drug,
its
cost
also
raises
key
questions
about
how
accessible
this
“miracle
drug” can
be.
“How
is
it
going
to
help
us?
Because
I’m
sure
it’s
for
the
rich,” a
Ugandan
citizen
told
DW,
reacting
to
the
$40-dollar
yearly
cost
of
the
drug,
which
was initially
projected
to
cost
about
$28,000
(€24,197)
per
person
annually.
The
lenacapavir
prevention
regimen
also
requires
an
initial
oral
dose
when
starting
the
regimen: two
tablets
to
be
taken
on
the
day
of
the
first
injection
and
two
tablets
to
be
taken
on
the
following
day.
To
address
cost
concerns,
Nyika
suggested negotiations
by
middle-
and
low-income
countries
and
possible
local
or
regional
production.
“These
can
help
bring
the
cost
down,
but
also
leveraging
the
existing
supply
chain,
community
health
system
and
different
service
delivery
modules
will
help
ensure
equitable
access,”
Nyika
said.
Partnership
with PEPFAR and
the
Global
Fund
is
expected
to
significantly
reduce
the
pricing
of
the
“miracle
drug.”
Kenya,
Nigeria,
Zambia,
Uganda,
Tanzania,
South
Africa,
Eswatini
and
Botswana
are
also
among
those
countries
selected
for
the
rollout
by
January
2026.
Cai
Nebe
and
Isaac
Mugabi
contributed
reporting.
This
article
has
been
adapted
from
an
episode
of
DW’s
AfricaLink
podcast.